Stenotrophomonas maltophilia is considered one of the emerging bacterial agents causing healthcare-associated infections (HAIs) in hospital environments. This microorganism has been identified as multidrug-resistant, capable of forming mature biofilms—an ability that promotes adherence to surfaces and invasive medical devices, favoring persistence in hospital environments and the potential to generate outbreaks. The aim of this study was to characterize S. maltophilia strains isolated from HAI cases at the Hospital Juárez de México and to determine the presence of hidden outbreaks. Antibiotic resistance profiles were determined, along with the typing of 20 genes associated with virulence factors and the assessment of the ability to form mature biofilms on inert surfaces. Finally, sequence type (ST) was obtained through multilocus sequence typing (MLST) analysis, and a phylogenetic tree was constructed to determine the clonal diversity of the isolates. All strains showed uniform resistance to β-lactam antibiotics tested while remaining sensitive to fluoroquinolones, phenicols, tetracyclines, and trimethoprim/sulfamethoxazole. Some isolates exhibited adherent activity, with the “strong biofilm-former” phenotype predominating. Sixteen virulence-related genes were heterogeneously detected, revealing broad genetic diversity. MLST analysis grouped the isolates into nine ST related to infection cases reported in others countries. Phylogenetic analyses demonstrated the presence of three potential clones distributed across Internal Medicine and the Pediatric Intensive Care Unit. These results highlight the importance of investigating S. maltophilia as an HAI-associated pathogen that remains understudied.

Empirical use of antibiotics in the treatment of eye infections leads to bacterial pathogens becoming resistant to antibiotics; consequently, treatment failure and eye health complications occur. The aim of this study was to describe the phenotype and genotype of the resistance and adherence of bacterial agents causing eye infections in patients at Hospital Juárez de México. An observational, prospective, cross-sectional, and descriptive study was carried out in patients with signs and symptoms of ocular infection. Bacterial agents were isolated and identified by classical microbiology and mass spectrometry. Antibiotic resistance and adherence profiles were determined. Finally, resistance (mecA/SCCmec) and virulence (icaA and icaD) genes were detected in the Gram-positive population. The results showed that blepharitis was the most prevalent condition in the study population. A MALDI-TOF analysis revealed that Staphylococcus and Pseudomonas genus were the most prevalent as causal agents of infection. Resistances to β-lactams were detected of 44 to 100%, followed by clindamycins, aminoglycosides, folate inhibitors, and nitrofurans. A multiple correspondence analysis showed a relationship between mecA genotype and β-lactams resistance. The identification of SCCmecIII and SCCmecIV elements suggested community and hospital sources of infection. Finally, the coexistence of icaA⁺/icaD⁺/mecA(SCCmecIII) and icaA⁺/icaD⁺/mecA(SCCmecIV) genotypes was detected in S. aureus. The identification of resistant and virulent isolates highlights the importance of developing protocols that address the timely diagnosis of ocular infections. Herein, implications for the failure of antimicrobial therapy in the treatment of ocular infections in susceptible patients are analysed and discussed.

The Ocular Trauma Score (OTS) is a scale that estimates the prognosis of injured eyes after treatment, whose results are consistent with those of longitudinal studies. The time between injury presentation and initial care has been described as a prognostic factor for visual outcome, but the OTS features of eyes receiving early or late care after trauma have not been compared. Non-experimental, comparative, retrospective, cross sectional study. Patients from either gender, aged 5-80 years, with open globe trauma, without previous diseases that reduced visual acuity or previous intraocular surgery were included. The distribution of the OTS variables was identified. The sample was divided in two: group 1 (time between trauma occurrence and initial care ≤ 24 hours) and 2 (time > 24 hours). The frequency of OTS categories of unfavorable prognosis (1-3) was compared between groups (χ(2)). 138 eyes of 138 patients, mean age 28.8 years, 65.2% male. The evolution time ranged 2-480 hours (mean 39.9); 103 eyes were assigned to group 1 (74.6%), and 35 to group 2 (25.4%). The proportion of categories 1-3 in group 1 (82.5%, n = 85) did not differ from that in group 2 (80%, n = 28; p = 1.0). The proportion of OTS categories with unfavorable prognosis did not show significant differences between the eyes who received care before or after 24 hours that could contribute to a different outcome, besides the delay in starting treatment.